Occlusione intestinale da carcinoide ileale

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COD: 457-462-min Categorie: ,

Giuseppe Marzocca, Edda Caputo, Fabrizio Varrone, Marianna Lo Gatto, Barbara Rocchi, Salvatore Polito, Franca Sorbellini.

Ann. Ital. Chir., 2008; 79: 457-461

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OBJECTIVE: Ileal carcinoids diagnosis, generally, is late because patients have aspecific symptoms.
MATERIAL OF STUDY: The two cases described presented for a long time peristaltic abdominal pains, vomit episodes and reduction of weight, with negativity of radiologic reports. The first diagnosis was adhesional syndrome produced by previous abdominal surgical operation; just emergency surgical operation executed for intestinal occlusion noticed carcinoids, located into the distal ileum, which infiltrated muscular wall and interested regional lymphonodes. RESULTS: Ileal carcinoids diagnosis, generally, takes place during emergency laparotomy for intestinal occlusion which is the most frequent complication of this tumor. At the moment of diagnosis the tumor presents an advanced stage of evolution.
DISCUSSION: Ileal carcinoids behave malignant because of their biologic aggressiveness and because of at the moment of diagnosis they present an advanced stage of evolution. Symptomatology is aspecific, just a carcinoid syndrome could addressed clinical diagnosis, but this is an rare event and however it needs of liver metastases to appear. In case there is an clinical suspect scintigraphy with Octreoscan can locate tumor and metastases.
CONCLUSIONS: Surgical treatment of ileal carcinoids is based on large resections en bloc. Ileal carcinoids survival to 5 years is estimated inferior to 60% after surgical treatment.

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